A 23-year-old man, diagnosed with Wolff-Parkinson-White syndrome and who had undergone several catheter ablations, presented 2 months after the most recent ablation with cardiac tamponade following physical exertion. Emergency surgery revealed a perforation between the inferior vena cava and the right atrium. This perforation was repaired with a bovine pericardium patch. To our knowledge, this is the first case of delayed cardiac tamponade after catheter ablation due to a Valsalva manoeuvre (such as weightlifting) in a patient with a normal international normalized ratio and normal platelet count.